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Periodontics · single question

A healthy patient presents with a fractured distolingual cusp of tooth #32 and an ulcer on the adjacent tongue. What should you do FIRST?

  1. Restore the fractured cusp or smooth the sharp margin
  2. Prescribe antibiotics for the ulcer
  3. Refer to oral surgery
  4. Take an incisional biopsy of the ulcer
Show answer and explanation

Correct answer: A. Restore the fractured cusp or smooth the sharp margin

The ulcer is traumatic in origin — caused by the sharp fractured cusp irritating the tongue. The correct first step is to restore the fracture or smooth/round the sharp margin. Removing the source of trauma will allow the traumatic ulcer to heal. A biopsy is NOT indicated at this time — biopsy of a traumatic ulcer before eliminating the cause would be premature and incorrect management. If the ulcer persists for 2 weeks after removing the irritant, then biopsy is indicated.
  • A. ✅ CORRECT – Restore or smooth the fractured cusp to eliminate the trauma source. The traumatic ulcer will heal once the irritant is removed.
  • B. ❌ Antibiotics are not indicated for a traumatic ulcer — it is not an infection.
  • C. ❌ Referral to oral surgery is not indicated for a traumatic ulcer caused by a sharp tooth.
  • D. ❌ Biopsy of a traumatic ulcer BEFORE removing the causative factor is incorrect. Remove the cause first; biopsy only if it fails to heal in 2 weeks.

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